During orthopedic surgical procedures, when a c-arm is utilized and spot images are submitted for interpretation, can we bill for both the fluoro guidance and the images taken?
March 30, 2009
When fluoroscopy (7600X) is used during the performance of most operating room / surgical orthopedic procedures (2xxxx), it is incorrect to submit 76000 or 76001, as the fluorocospy is not considered a separate procedure, per the national correct coding initiative (NCCI) edits. In these instances, the fluoroscopy is considered to be an integral part of the open or closed orthopedic service.
Modifier 59 may only be assigned to a fluoroscopy code for orthopedic procedures when there is NOT a NCCI edit. If there is an edit, then do not report fluoro unless the service is for a different procedural service or encounter that occurred on the same date of service.
Images that are obtained during an intraoperative procedure, either from a portable or a fluoroscopic C-arm unit, may be charged as a radiographic procedure, when radiographs are requested by the physician and when interpreted by the radiologist / physician as permanently documented in the medical record.